Insomnia: A Narrative Review of Treatment Strategies For The Most Prevalent Sleep Disorder
DOI:
https://doi.org/10.12775/JEHS.2025.84.66929Keywords
Sleep Initiation and Maintenance Disorders, Insomnia, Cognitive Behavioral Therapy, Chronotherapy, Hypnotics and Sedatives, Orexin Receptor Antagonists, Melatonin, Antidepressive Agents, Antihistamines, Complementary TherapiesAbstract
Background: Insomnia is the most prevalent sleep disorder, associated with impaired daytime functioning, increased risk of mental and physical illness, as well as social and economic burden.
Aim: This review summarizes the current state of knowledge on insomnia disorder and assesses the clinical value of scientifically proven treatment strategies, including both pharmacological and non-pharmacological methods.
Methods: A narrative literature review was conducted using PubMed/MEDLINE (January 2015- November 2025). Peer-reviewed human studies, clinical guidelines, systematic reviews, meta-analyses, and high-quality narrative reviews addressing definition and classification, epidemiology, mechanisms, consequences, diagnostic tools, or treatment outcomes were included.
Results: Insomnia affects approximately 10% of the adult population and is more common in women, elderly people, individuals with chronic stress, and those with comorbid medical or psychiatric conditions. Evidence supports a multidimensional hyperarousal model as the core mechanism of insomnia pathophysiology. Insomnia is linked to a higher risk of anxiety, depression, cardiometabolic disease, cognitive impairment, accidents, and reduced quality of life. Diagnosis relies on clinical assessment supported by sleep diaries and validated questionnaires. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment, with chronotherapy, mindfulness-based interventions, exercise, and complementary approaches as useful adjuncts. Pharmacological options, including benzodiazepines, "Z-drugs", and other medications, may be considered, but with careful monitoring of safety and potential dependence.
Conclusions: Insomnia requires personalized care that prioritizes non-pharmacological strategies. Medications should be used with caution, for selected patients, and for short durations only. Early recognition, patient education, and wider access to CBT-I are essential to reduce the burden of insomnia.
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Copyright (c) 2025 Klaudia Martyna Patrzykąt, Paula Marcinkowska, Ewelina Nowicka, Kinga Popielarska, Marta Krzyżaniak, Izabela Brynczka, Julia Puzio, Zofia Gorzoch-Burduk, Michał Jezierski, Kamila Wróblewska
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